Congestive Heart Failure and Quality of Life

Our study aimed to assess the quality of life (QoL) of patients with congestive heart failure (CHF) and to correlate the different aspects of QoL with relevant socio-demographic variables, CHF severity, somatic comorbidities, other clinical variables and depressive symptomatology. In a cross-sectional study design, a community sample of 103 adult patients with CHF (mean age 68 years, 73 % male) was recruited from an outpatient cardiology practice. CHF severity was assessed with physician ratings of the New York Heart Association (NYHA) functional class and measurement of brain natriuretic peptide (BNP) levels. The psychometric evaluation of quality of life was made using the Medical Outcomes Study Short Form-36 (SF-36) and the Kansas City Cardiomyopathy Questionnaire (KCCQ). The Beck Depression Inventory Second Edition (BDI-II) assessed depressive symptoms. Using multiple linear regression, predictors of poorer QoL included being a female, being older, living alone, NYHA functional class ≥ II, higher levels of BNP comorbidity (such as renal insufficiency and cerebrovascular disease), fluid retention, depressive symptomatology (assessed by BDI-II) and treatment with anti-dyslipidemics, diuretics and β-blockers. Among these correlates, psychological distress was the most strongly related to QoL. Also, functional status measured by NYHA demonstrated a high impact on QoL. Our findings suggest the need to address such factors in developing effective care to improve psychological and functional status in order to enhance QoL in these patients.     

Beyond home-based family intervention: A multi-family approach toward change

A growing specialty area in the mental health field involves working with emotionally disturbed youth and families-at-risk by providing services in the context of the home environment. A review of the literature provides documentation for family systems, social learning, and ecological interventions with at-risk families receiving home-based intervention but there is an absence of material on the use of multi-family groups with this population. The purpose of this article is to outline the implementation of a multi-family therapy (MFT) component for home-based programs serving at-risk families. Advantages and disadvantages when using MFT are also addressed.The authors are grateful to Linda Pannell for her helpful comments on drafts of this article.     

Simulation Studies of Descending and Reflex Control of Fast Movements

Several neurological control strategies for fast head movements are considered using computer simulations of a stretch reflex model. Each control strategy incorporates a different amount of proprioceptive feedback contributing to braking and/or clamping the movement. The model behavior for each control strategy is qualitatively compared to experimental data that includes the agonist and antagonist EMGs, and the head position, velocity, and acceleration. Significance of the study is discussed with respect to the characteristic tri-phasic EMG pattern for fast voluntary movements and the possible roles that the stretch reflex may have in contributing to this pattern of activation.     

A modest/immodest proposal: Reciprocal foster families

In this article we describe the concept of reciprocal foster families a strength-based approach to helping families in poverty. This approach focuses on the resources that all families have to offer each other. The goal of reciprocal foster families approach is to restrict the role of professionals and develop trust in the intuitive wisdom of natural networks of people and families as they help each other succeed in times of difficulty.     

Menopausal Symptoms: Is Spirituality Associated with the Severity of Symptoms?

The aim of this study was to explore whether spirituality was associated with menopausal symptoms. Menopausal symptoms, spirituality, health and menopausal status, and socio-demographic variables were assessed in a community sample of 710 peri- and postmenopausal women. A structural model was explored using structural equation modeling. The results evidence spirituality as a significant contributor regarding the severity of most menopausal symptoms. Among others, spirituality had a significant weight in depressive mood (β = ?.414; p < .001), anxiety (β = ?.308; p < .001), cognitive impairment (β = ?.287; p < .001), aches/pain (β = ?.148; p < .001), vasomotor (β = ?.125; p = .005) and sexual symptoms (β = ?.211; p < .001). Some socio-demographic variables, as well as perceived health, also predicted the menopausal symptoms’ severity. Therefore, spirituality can have a positive impact on the menopausal symptoms’ reporting.     

What Does Psychological Autopsy Study Tell Us About Charcoal Burning Suicide—A New and Contagious Method in Asia?

Charcoal burning suicides in Hong Kong between 2002–2004 in the 15 to 59‐year‐old age group were investigated using the psychological autopsy method. The psychopathological profiles of charcoal burning suicides (N = 53) were compared against “other suicides” (N = 97). The two groups did not differ significantly in the prevalence of DSM‐IV axis I diagnoses with the exception of schizophrenic spectrum disorder which was less frequently associated with charcoal burning suicides. Score on “neuroticism” in the NEO‐five Factor Inventory (NEO‐FFI) was significantly higher in victims of charcoal burning suicide. There was also a trend toward higher score on “conscientiousness” in the NEO‐FFI among charcoal burners than victims of other suicide.     

The differential outcomes procedure can interfere or enhance operant rule learning

The differential outcomes effect—the enhancement of learning and memory performance by correlating distinct reinforcers with to-be-remembered events (sample stimuli)—has been stated to be one of the most robust phenomena in learning psychology. However, in this paper we demonstrate that the correlation between unique samples and unique reinforcers can either interfere with or enhance learning a spatial matching-rule, dependent on whether these two processes are trained concurrently or sequentially. If the Pavlovian conditioning (unique sample-reward pairings) occurs before the matching rule is learned (sequentially), the conditioned expectations of unique rewards will enhance the acquisition of the spatial matching-rule in rats (the differential outcomes effect will be observed). However, if rats are required to learn the Pavlovian associations and the matching-rule concurrently, they are impaired in acquiring the spatial matching-rule. Thus, employing the differential outcomes procedure can either enhance or detract from learning and remembering the task rule—dependent on the nature of the task and order of training. These data suggest that under some circumstances learning Pavlovian associations can compete with the formation of instrumental behavior.